Depessive Disorders Flashcards
Criteria A symptoms for MDD
MSIGECAPS
Mood decreased
Sleep increased/decreased
Interest decreased
Guilt/worthlessness
Energy decreased
Concentration decreased
Appetite decreased/increased
Psychomotor agitation/retardation
Suicidal ideation
DSM for MDD
A: >/= 5 depressive symptoms for more than 2 weeks
B: significant distress and impaired functioning
C: Not caused by another MC or substances
D: MDD not better explained by another psychiatric condition
E: no history of manic or hypomanic episodes
Specifiers for MDD
Anxious distress - tense, distress, despair
Catatonia
Psychotic - mood congruent/incongruent
Atypical features - hypersomlence, weight gain
Melancholic features (worse in morning) - despondent, despair, psychomotor changes
Peripartum - <4 weeks onset
Seasonal features
Difference between grief and MDD
Grief
>predominant feeling of loss and emptiness
>comes in waves
>gets less over time/decreases in intensity (days/weeks)
>thoughts centred around death of decreased
>thoughts/memories of loss
>preserved self esteem
MDD
>persistent depressed mood and unable to anticipate happiness
>not tied to specific thoughts
>suicidal ideation
>low self esteem/feelings of worthlessness
>self critical and pessimistic
What to consider in a MDD patient with a poor response
SE profile of drug
Previous response
Comorbid conditions
Reassess compliance, substance use, diagnosis, comorbidity
DSM for persistent depressive disorder (dysthymia)
A: symptoms for >2years in adult and >1in child (irritable)
B: >/=2 symptoms (SIGECAPS), while depressed - NO SUICIDAL IDEATION, PSYCHOMOTOR AGITATION, GUILT, anhedonia)
C: never without symptoms for >/=2 months
D: not due to AMC or substance
E: not caused by another mental disorder
F: no manic or hypomanic episodes
G: causes significant distress or functional impairment
Pathophysiology for depression
Hyperactive HPA axis = increased cortisol, dendritic loss and inflammation, decreased protein synthesis
